Pain affecting the back, often restricting movement. Is usually caused by minor damage to the ligaments and muscles in the back. The Lower back is especially vulnerable to these problems because it supports most of the body’s weight and is under continual stress from movements such as bending, twisting.

In the UK back pain accounts for the greatest loss of work hours, and 80% of the population will experience back pain in their lives. Today’s lifestyle creates an insidious strain on the back, stressing the soft tissues and predisposing them to injury.

Causes of Back Pain

There are many possible causes of back pain including:

·Scoliosis

·Spondylolisthesis ( a forward slip of one vertebra on another )

·Spinal stenosis ( a decreased diameter of the spinal canal )

·Leg length inequality

·Joint hypermobility

·Scheuermann’s disease ( spinal osteochondrosis )

·Osteoporosis

·Muscle imbalance

·Pregnancy

·Ankylosing spondylitis

·Poor posture

Back pain varies in type depending on its cause. It can originate from a mechanical or chemical disturbance of tissue or a combination of both. Pain can be experienced either locally, at the site of injury, or it can be referred into more distant areas.

Low Back Pain

Low back pain which affects nearly every one of us at some stage of our active adult life.

To most people low back pain remains a mystery. It often starts without warning and for no obvious reason. It interferes with simple activities of living.

The causes of most kinds of low back pain are quite clear.

Common causes of low back pain

The most of common cause of low back pain is postural stress.

Thus low back is frequently brought on by sitting for a long time in a poor position or prolonged bending in bad working positions; heavy lifting and standing for a long time in a poor position.

Some people, who habitually adopt poor postures experience back pain throughout their lifetime.

The habitual poor posture causes changes to the structure of the joints and consequently premature ageing of the joints.

The effects of poor posture in the long term, therefore, can be just as severe and harmful as the effects of injury.

Sitting for Prolonged Periods

Most people sitting for prolonged periods will adopt a poor posture. Sitting in a bad position for a few minutes causes the muscles that support the low back become tired and relax. This results in the slouched sitting posture. A slouched sitting posture for long time will cause overstretching of ligaments.

Once the slouched sitting posture has become a habit and is maintained most of the time, it may also cause distortion of the discs contained in the vertebral joints. Once this occurs movements as well as positions will produce pain.

It follows that people with sedentary office jobs easily develop low back pain problems as they often sit with a round back for many hours.

Working in Stooped Positions

When standing with your back straight the stress on discs and ligaments in your low back are considerably lower than when you stand with your back bent forwards. Many activities around the home may cause you to bend – for example gardening, hovering etc.

When working in these bent positions, you are more likely to sustain back problems.

Lifting

Lifting objects with your back rounded has been found to raise the pressure in the discs to a much higher level than that existing when the weight is held with the body upright and the lordosis present.

If you use an incorrect lifting technique while lifting heavier objects, you may cause damage and, of course, sudden severe pain.

In order to minimise the risks involved in lifting you should always use the correct lifting technique.

Prolonged Standing

When standing for long periods the muscles that support you tire and relax, allowing you to slouch. When you stand relaxed, however, the lordosis becomes excessive and the low back hangs in an extreme position. This is exactly the opposite position to that adopted by the spine when you sit slouched. It is not possible to stand in this way for long periods as the excessive lordosis is a position of strain.

Lying and Resting

Some people have low back pain when they are lying resting in certain positions. If you have low back pain only when lying down, or if you regularly wake in the morning with a stiff and painful low back that was not painful the night before, there is likely to be something wrong with the surface on which you are lying or the position in which you sleep.

Coughing and Sneezing

Coughing and Sneezing while you are bent forwards or sitting may cause a sudden attack of low back pain or aggravate existing back pain.

Guidelines for back pain

1/ Posture in lying

- Hard beds - the effects on the spine when sleeping on a hard surface are shown on the picture. Lying supine the lumbar spine is either unsupported or it falls into flexion with the pull of gravity flattening the curve. In side lying, the waist is unsupported, so the lumbar spine falls into a scoliotic-type curve towards the mattress.

- Soft beds - soft beds are the worst of all evils, they sag in the middle where the body is heaviest encouraging loss of good spinal shape in every position.

- Firm beds - the ideal bed has a very firm base with a mattress that is sensitive to small changes of pressure on the surface, accommodating superficially to all the body protuberances but remaining supportive of natural body hollows.

2/ Posture in lifting, carrying, pulling and pushing.

Lifting, carrying, pulling and pushing all involve conveying or moving an object or person from one position to another, they all place a hazardous strain on the body, especially on the back.